Sec. 2210.059. CLAIMS PRACTICES AUDIT. (a) The commissioner, in the manner and at the time the commissioner determines to be necessary, shall conduct a random audit of claim files concerning claims the bases of which are damage to insured property caused by a particular storm to:
(1) determine whether the association is adequately and properly documenting claims decisions in each claim file; and
(2) ensure that each claim is being handled appropriately, including being handled in accordance with the terms of the policy under which the claim is filed.
(b) The department shall conduct an audit required under this section as soon as possible to ensure the quality of the process with which the association is handling claims described by Subsection (a).
(c) If, following an audit conducted under this section, the commissioner determines that the association is not adequately and properly documenting claims decisions or that claims described by Subsection (a) are not otherwise being handled appropriately, the commissioner shall:
(1) notify the board of directors of that determination; and
(2) identify the manner in which the association should correct any deficiencies identified by the commissioner and issue an order to that effect.
Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 2 (H.B. 3), Sec. 9, eff. September 28, 2011.
Structure Texas Statutes
Title 10 - Property and Casualty Insurance
Subtitle G - Pools, Groups, Plans, and Self-Insurance
Chapter 2210 - Texas Windstorm Insurance Association
Subchapter B. Administration of Association
Section 2210.051. Composition of Association; Required Membership
Section 2210.052. Member Participation in Association
Section 2210.053. Operation of Association
Section 2210.054. Annual Statement
Section 2210.055. Legal Counsel
Section 2210.056. Use of Association Assets
Section 2210.057. Examination of Association
Section 2210.058. Audit of Association
Section 2210.059. Claims Practices Audit
Section 2210.060. Indemnification by Association
Section 2210.061. Contractors and Managerial Employees: Compensation and Bonuses
Section 2210.062. Administration by Contracted Administrator Authorized